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General NPI Number Information
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NPI Number | 1881295228
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Entity Type | Individual
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Provider Name | VIVIAN HOA NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 7401 PARK VISTA BLVD
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City | FORT WORTH
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State | TX
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Zip | 76137-3769
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Country | US
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Telephone | 817-605-0404
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Fax | 817-605-0413
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Provider Business Mailing Address
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Address Line | 5336 ELMDALE DR
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City | WATAUGA
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State | TX
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Zip | 76137
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Country | US
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Telephone | 817-271-5606
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 40043
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License Number State | TX
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